Responsible Controlled-Substance Prescribing

The management of patients with acute and chronic nonmalignant pain represents a real challenge for practicing clinicians. The chronic use of opioids now carries an “addiction-related” stigma and concerns about efficacy and safety of opiates have been called into question. Overprescribing of opioids and opiates by clinicians in various disciplines remains a serious public health concern and a major contributor to the opioid epidemic. According to the Centers for Disease Control and Prevention (CDC), about 40% of opioid-related deaths can be attributed to prescriptions of opioids. Excessive opioid prescribing may be in part due to significant limitations in medical education curricula and residency training around addiction and aberrant opioid use behavior. Clinicians should consider adopting policies for opioid prescription during pain management that closely align with the current CDC guidelines. This chapter provides effective strategies that promote responsible and conscientious controlled substance prescribing in the clinical setting